HomeMy WebLinkAboutDrain Layers Permit 704 Summer Hill Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: -3 10-5LZ�.�
DRAIN LAYER'S PERMIT Nu 2642
3 , 19$
Pursuant to written appli atior permission is h reby ranted to the Licensed Drin Layer named herein to perform
the work indicated below at d U' l he
side, beAween
at premises owned by QUC U7�Le b t l ,^ ( -K
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES _( ), OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License;No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. —and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
r ) Signed
innection Charge Paid ,��' (� 3 t a Licensed Drain Layer
Issued by
T�1 Cs lle o�l j
Permit Fee:. Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)